RESUMEN
BACKGROUND: In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston area, only two school districts - the Boston and neighboring Chelsea districts - sustained masking requirements through June 2022. The staggered lifting of masking requirements provided an opportunity to examine the effect of universal masking policies on the incidence of coronavirus disease 2019 (Covid-19) in schools. METHODS: We used a difference-in-differences analysis for staggered policy implementation to compare the incidence of Covid-19 among students and staff in school districts in the greater Boston area that lifted masking requirements with the incidence in districts that sustained masking requirements during the 2021-2022 school year. Characteristics of the school districts were also compared. RESULTS: Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time. Districts that chose to sustain masking requirements longer tended to have school buildings that were older and in worse condition and to have more students per classroom than districts that chose to lift masking requirements earlier. In addition, these districts had higher percentages of low-income students, students with disabilities, and students who were English-language learners, as well as higher percentages of Black and Latinx students and staff. Our results support universal masking as an important strategy for reducing Covid-19 incidence in schools and loss of in-person school days. As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded.
Asunto(s)
COVID-19 , Política de Salud , Máscaras , Servicios de Salud Escolar , Precauciones Universales , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Incidencia , Pobreza/estadística & datos numéricos , Instituciones Académicas/legislación & jurisprudencia , Instituciones Académicas/estadística & datos numéricos , Estudiantes/legislación & jurisprudencia , Estudiantes/estadística & datos numéricos , Política de Salud/legislación & jurisprudencia , Máscaras/estadística & datos numéricos , Servicios de Salud Escolar/legislación & jurisprudencia , Servicios de Salud Escolar/estadística & datos numéricos , Grupos Profesionales/legislación & jurisprudencia , Grupos Profesionales/estadística & datos numéricos , Precauciones Universales/legislación & jurisprudencia , Precauciones Universales/estadística & datos numéricos , Massachusetts/epidemiología , Control de Enfermedades Transmisibles/legislación & jurisprudencia , Control de Enfermedades Transmisibles/estadística & datos numéricosAsunto(s)
Antibacterianos/uso terapéutico , Economía del Comportamiento , Prescripción Inadecuada/prevención & control , Pacientes Ambulatorios/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Antibacterianos/efectos adversos , Toma de Decisiones Clínicas , Humanos , Prescripción Inadecuada/economía , Pautas de la Práctica en Medicina/economíaRESUMEN
The early phase of the coronavirus disease 2019 (COVID-19) pandemic and ongoing efforts for mitigation underscore the importance of universal travel and symptom screening. We analyzed adherence to documentation of travel and symptom screening through a travel navigator tool with clinical decision support to identify patients at risk for Middle East Respiratory Syndrome.